2008 Presidential Campaign Platforms How Managed Health Care Issues Impact Us All
With the 2008 elections in full swing, several presidential candidates are proposal changes in the way our country looks at healthcare. With universal healthcare as a priority issue for many voters, the presidential candidates are hoping to not only entice the voters with their pledges to end the Iraq war, but also to ensure every American has access to health coverage.
At display, in the United States, there is a growing concern over the mismanagement of managed care programs, such as HMOs. Because those insured under managed care programs often report complications associated with access to healthcare, there are many American voters who will vow to only vote for the candidate who can bring a major impact to healthcare reform.
So, why is our modern health care system not working? For managed healthcare plans, such as HMOs, statistics have reported they have an overwhelming imbalance of profits, from premiums, versus claim payments. In fact, with managed care, very little is paid in terms of claims as doctors, hospitals and other “in-network” health providers are paid a flat monthly fee for all patients enrolled, and assigned, to their care. For this reason, there isn’t great incentive for a healthcare provider to make the appropriate referrals to specialists and outside care facilities as this would result in dollars lost to clinic or physician.
When considering a managed care conception, there are several factors you should reflect before choosing which plan is right for your family. It is valuable to first remember that the sales person, employed by the managed care plan, is there to promote a product they feel is best. In many cases, it may be vital to shop around and find the plan that is good for your family. Check with your state insurance board as, oftentimes, they can supply a history of complaints and lawsuits that have been filed against the particular managed care plans you are considering.
In addition to investigating the plan’s history and credibility, it is important to also take a look at the managed care plan’s list of preferred providers. While many potential insureds look at the list to confirm their primary care physician is contracted, we often fail to look at the list to confirm clear physicians are present in specialty areas, i.e. gynecologist, obstetrician or ophthalmology.
In addition to managed healthcare plans, many companies are now turning to managed dental care plans as well. While these plans are not quite as popular, they are being offered in many employment settings as a way to slash costs. Again, before selecting a managed dental care plan, investigate the reputation of the company and contact the dental provider to determine the length of time you can expect to wait before an appointment becomes available for services.
With nearly 85 percent of the adult population currently insured by managed care plans, there continues to be a growing health care crisis in the United States, especially when these figures are coupled with the millions of Americans who continue to be uninsured. While managed healthcare is better than no healthcare at all, it is significant to know what you are purchasing and make the best healthcare decision for your family.
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Filed under United Health Care by on Jan 19th, 2012. 